Saliva test that accurately detects concussion in rugby trial hailed as ‘game-changing’ breakthrough

A saliva test has been found to accurately detect concussion in elite male rugby players, possibly paving the way for such injuries to be diagnosed during a game across a range of sports in the future.

The SCRUM study, led by academics at the University of Birmingham, developed a test using biomarkers within saliva which could successfully predict the outcome of a head injury assessment (HIA) in 94 per cent of cases during testing in the 2018-19 Premiership and Championship rugby season.

The technology behind rapid coronavirus testing could ultimately be used to help develop a device which provides an objective in-game diagnosis of concussion, alongside existing assessment techniques.

The breakthrough has been described as a "game-changer" by the SCRUM team, who now hope to trial the tests in two further elite men's rugby competitions after they have presented their findings to World Rugby's Law and Welfare Symposium next week.

It comes at a time when the sport's authorities face a legal claim from former players who have been diagnosed with early onset dementia, and amid a parliamentary inquiry into the treatment of head injuries in sport.

The study was carried out in collaboration with the Rugby Football Union, Premiership Rugby and Marker Diagnostics, and the RFU's medical services director, Dr Simon Kemp, said: "Within the elite professional game, men's and women's, it would be ideal to have an in-game test.

"It's a relatively small population of games you need to support and this test needs to be part of an HIA framework."

Premiership Rugby has indicated its willingness to support the next stage of research in the 2021-22 season, and the group also wants to expand the study into women's sport, where it is expected different biomarkers will need to be identified.

The development of an over-the-counter test could also have benefits for grassroots rugby players. The medical advice at that level is to immediately remove any player who has suffered any kind of head impact, but the test could be done post-match to determine whether a concussion had been suffered or not, allowing players even at the community level to make informed decisions about returning to play.

"Concussion can be difficult to diagnose, particularly in settings such as grassroots sports where evaluation by a specialist clinician is not possible," study first author Dr Valentina Di Pietro said.

"Consequently, some concussions may go undiagnosed. There are also concerns regarding the long-term brain health of those exposed to repeated concussions.

"A non-invasive and accurate diagnostic test using saliva is a real game-changer and may provide an invaluable tool to help clinicians diagnose concussions more consistently and accurately.

"In professional sports, this diagnostic tool may be used in addition to current head injury assessment protocols and return to play evaluation to ensure the safety of individuals."